Fever and Morbilliform Rash in an International Adoptee with Human Immunodeficiency Virus Infection

Abstract

International adoptees may arrive with medical records that are incomplete or inaccurate. Errors may have occurred in the process of transitioning the child into a new health-care system. Available records should be scrutinized and corroborated with history and laboratory studies when possible. • There is a broad differential diagnosis for the child with fever and rash. Certain etiologies should be considered in the setting of incomplete vaccination, international travel, and human immunodeficiency virus (HIV) infection. • Children with HIV infection can have fever and rash due to opportunistic infections or drug reactions. Drug rashes are more common in patients with HIV infection. The severity ranges from mild localized reactions to diffuse rashes with severe systemic illness. Nevirapine is the antiretroviral medication most commonly associated with drug rashes.